Dr. Viral Patel (Internal Medicine) needs a second opinion on this medical case.
65 year male with shortness of breath
C/O Shortness of breath since last 1 month. Progressive from NYHA 2 to 4.
C/O Cough most of the times non-productive for last 2 months.
C/O fever intermittent since last 1 month
Weight loss of nearly 10 kgs in 2 months.
Smoker otherwise no comorbidities.
Saturation 80% on air
Heart Rate :- 120/min
Respiratory examination revealed Absent Air entry on left side
Sputum AFB n C&S negative
Sputum Cytology revealed Atypical cells clusters highly suggestive of malignancy.
PLAIN CT THORAX confirmed left sided Hydropneumothorax. Contrast was avoided due to altered renal function.
Repeat scan has been planned after ICD insertion.
ICD inserted on left side. Clinically patient has stabilised vitally. With FiO2 32% patient is maintaining saturation around 94-95%. Antibiotics, IV fluids n supportive therapy is ongoing.
Further management has been planned as per follow up CECT with ICD in situ to confirm malignancy n manage accordingly.